The Covid-19 pandemic has left its mark - in obvious and more subtle ways. It has forced surviving businesses to quickly reframe and repurpose their services and profit models to a next and then a new normal of changing consumer expectations. Healthcare in general has not been very responsive to consumers’ desires and demands. One example of healthcare reacting to the pandemic, comes via the outcomes of the high utilization of telemedicine (from less than 1% to 13% of outpatient visits during the first six months of the pandemic). Had we maintained the normal trajectory of innovation in healthcare, we would not have seen the accelerated rise of digital healthcare delivery.
Peter Drucker has said, “the only legitimate business functions are marketing and innovation.” In short, attracting and keeping customers is the primary goal. Part of the work to accomplish that is to make things simpler and to increase value to the consumer. While easy to say, it’s hard to achieve. Employing these five components, health systems can grow their business’ profitability, while pushing towards a sustainable competitive advantage.
1. PATIENT & CONSUMER EXPERIENCE STARTS WITH THE PROVIDER EXPERIENCE
“Many companies are now on the bandwagon chasing the consumer experience. In our learning it’s the provider experience that comes first.” A healthcare tech company CEO (and friend) shared this sentiment. This feels instinctively right; if you don’t provide the functional tools and technologies for your team, it’s an impossible task for them to provide a meaningful experience for consumers.
However, a problem exists in our definition of the provider experience and how significant the gap is between our aspirations and reality. Rightly motivated, we continue to load our teams with more requirements, with dwindling time given to care delivery. There have been enormous investments made in various forms of data collection, information and analytics. In contrast, little attention and resources are spent translating the insights from data to comprehensively support caregivers and close the gaps that exist in a patient's overall care.
The industry talks about physical and digital space as though they are two separate care settings, which in itself is a telling narrative. From the consumer's perspective it is one care process. We often reflect on the difficulty and disconnect we experience as consumers, which may offer a glimpse into the broken processes that need to be redesigned.
Lastly, there is likely an additional and unexpected payback beyond the consumer experience improvements. The easier we make the experience for our team members, and the more we focus on giving control of care and connections with patients back to caregivers will augment the environment to stand out as a more desirable place to work.
2. DEVELOP AND INVEST IN A WELL-BEING BUSINESS AND STRATEGY, STARTING WITH YOUR OWN EMPLOYEES
While we are talking about the staffing challenges, it is important to understand the larger opportunity related to moving beyond wellness and focusing on well-being. We like the Gallup Organization and Blue Zones’ key components of well-being: purpose, social, financial, community, in addition to physical wellness. And we like that well-being is measurable.
There are three potentials with this strategy:
- Some of the best and fastest opportunities come from your own employees, especially as the likely majority of your workforce are women.
- This should be followed with the development of a business strategy with your local employers. The goal being to produce value for them, and create a formalized relationship to your health system.
- Finally, development of a well-being offering to the larger market, again, focused on women as the primary decision-maker for their families’ healthcare.
This may feel like unfamiliar space for many health systems as a business strategy that goes far beyond wellness-inspired marketing campaigns. The truth is, it is a new territory and will likely require something of a third space mindset and partners to successfully develop and operate. However, to ignore it may open the door to be further commoditized or worse disintermediated from the consumer. We see great possibility if approached aggressively by design-oriented, disciplined and innovative health systems.
3. IF YOU CARE WHERE PATIENTS GO THEN HELP THEM GET THERE
Health systems have invested hundreds of millions of dollars building out incredibly rich delivery networks and information infrastructure. However, they still depend heavily on patient self-navigation and ad hoc communications between providers to connect the dots. No other industry expects its customers (patients) and its professionals (clinicians) to handle core logistics, and with few tools and technologies to assist. The challenge is huge, ranging from staff and equipment inefficiencies to unsatisfactory information and navigation difficulties for our patients. We (almost without thinking) erect barriers that inevitably frustrate our customers.
If you think about it, companies like Uber and the airline industry have invested enormous resources to manage the logistics and ultimately the experience we as customers almost take for granted (until it doesn't work as we saw with Southwest recently).
In our view there are two foundational elements that need to be addressed. The first is an engagement process to understand both the immediate and longer-term needs of our customers (which as suggested in the previous section includes well-being services). The second element is full navigational features - which include live concierge support, digital connects, and intelligence and algorithms. In the end, to drive growth you need to know what your customers need and want and efficiently link them to it at scale.
4. BUILD OUT HOME-BASED CARE TO INCLUDE ACUTE HOSPITAL-AT-HOME
The idea of a care continuum is not new for healthcare operators. However, we observe several inhibitors to a deeper reimagining of its strategic role in health system strategy, particularly acute hospital-at-home:
- We have beds and buildings to pay for. (Part of the solution could be an Asset Smart Strategy, shared in section five below.)
- Second, payers and payment systems are focused on paying for segments of care. (It isn’t hard to think of a 30-day stay at home with appropriately decreasing resources along the way.)
- Lastly, the post acute settings are often not the core of a health system’s focus. It can be difficult integrating various continuum services and strategies. The logistics and communications are complex. (To achieve long term success will require much more sophisticated monitoring and AI.)
Like the developing dialogue about physical and digital services, being defined as simply, care; we think the dialogue about in-hospital or out-of-hospital care will become very similar, from the patients’ perspective - it's all care. And those health systems that get there first with a thoughtfully designed system of care will have significant advantages:
- In attracting patients
- Pushing past their facilities’ catchment areas for new growth
- Lowering total cost of care, and
- Improving patient outcomes.
5. INCREASE STRATEGIC FLEXIBILITY WITH AN ASSET-SMART FOCUS
This strategy begins with the development of a strategic real estate plan for your organization, aligned with your growth objectives. If you give credence to the above four strategies, then it also logically follows that you will need to become more flexible and smart about your asset base. As my friend Didier Choukran, CEO of Flagler Healthcare Investments, shared, “too often healthcare operations are being subsidized by their real estate, ultimately compromising their real estate returns.” In a recent study Flagler completed, there appears to be a correlation between how much real estate a health system owns with a lower overall return.
The ability to use data to better know when to own or lease can result in a major competitive advantage. Even when health systems find themselves in lower performing markets, the data used to justify those positions becomes paramount. There are many ways to better serve patients and create high value for the health system, such as locating physician specialties together that are complementary, and not over or under buy or lease space.
During Brian’s tenure leading a large health system it struck him in retrospect how little was understood about their real estate operations and the role it played strategically and operationally. In our experience this seems largely still true across the industry. Given the financial challenges ahead this area might be a literal goldmine of opportunity to better understand, organize, manage and even monetize.
We do not think this is a comprehensive list of everything that the next and new normal will require of us, as an industry, to be successful. They will yield multiple and cumulative returns for the investment of your resources. We are heartened by the truth that the last mile to excellence and competitive advantage is the least crowded.
Brian Paradis is the CEO and Founder at Csuite Growth Advisors, a healthcare advisory firm specialized in customer-valued growth, focused innovation, and sustained high performance. Most recently, Paradis served as President of AdventHealth’s Central Florida Region and as the Chief Financial Officer of AdventHealth’s Central Florida Region.
Ryan Paradis is a Growth Advisor with Csuite Growth Advisors. In previous roles, he has led multispecialty medical group operations. In addition to his role as a Growth Advisor, he serves as the Curated Solution Network's Director for Csuite Growth Advisors.